脳膿瘍の治療 : 自験41例の検討

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Forty-one patients with brain abscesses treated during 1965-1983 were reviewed. Group 1 consisted of 25 patients with abscesses who were treated before the availability of computed tomography (CT) scan (1965-1976); Group 2 included 16 patients treated with the aid of CT (1976-1983). One case in Group 1 has been reported by Fukawa et al. The mortality rate of patients in Group 1 was 16%, but no deaths occurred in Group 2. The overall mortality was 9.8%. The mortality rate was correlated most directly with deteriorating preoperative level of consciousness due to delay in diagnosis. The recent reduction in the mortality rate could be due to early diagnosis and accurate localization of brain abscess by means of CT. Bacteriological studies indicated that abscesses containing anaerobic bacilli have increased lately. A few more patients were treated by excision than by aspiration. No significant differences in the results of the two groups were noted with respect to the method of surgery. Approximately three-fourths demonstrated no subsequent neurological deficit, and returned to their previous level of functioning. It is suggested, however, that aspiration has a lower postoperative long-term seizure incidence than excision. It may be concluded at present that the aspiration method is the best, because this method does less damage to the brain and postoperative resolution of the abscess can be monitored accurately by CT.
日本脳神経外科学会の論文
1985-12-15

脳膿瘍の治療 : 自験41例の検討

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